64层CT阴性法胰胆管成像技术在胆道梗阻诊断中的应用

Clinical use of 64-slice spiral CT negative cholangiopancreatography to diagnose obstruction of bile duct

目的探讨64层CT阴性法胰胆管成像(N-CTCP)对胆道梗阻部位、范围、性质的诊断价值。方法2005年10月至2006年3月对临床诊断为梗阻性黄疸的14例病人行64层CT腹部增强扫描后进行表面阴影(SSD)、容积重建(VR)、多平面重建(MPR)、曲面平展(CPR)、最大密度投影(MIP)、间接最小密度投影(Imi-nIP),以及SSD+VR、MPR/曲面平展+MIP、thin-slab+MIP/VR重建。对该技术在判断胆道梗阻平面、梗阻性质以及胆管显示能力方面进行评价。结果N-CTCP图像质量优良。在细小胆管显示能力上,N-CTCP的MinIP重建逊于MRCP,但N-CTCP的SSD+VR重建效果与MRCP相当。对梗阻性质的诊断准确率N-CTCP为100%(14/14)。结论N-CTCP成像操作简单、快速,且较MRCP经济,可三维地显示胰胆管解剖结构及其周边器官、血管情况。其图像质量、显示细小胆管能力和对梗阻的诊断价值接近MRCP,具有较好的临床应用价值。

Objective To study the value of 64 -slice spiral CT negative cholangiopancreatography（N-CTCP） to diagnose the level, range and character of obstruction of bile duct. Methods 14 obstructive jaundice patients determined by clinic or lab testing from Oct. 2005 to Mar. 2006, underwent 64 - slice MDCT with routine abdoment intensive scan. Then make SSD, VR, MPR, CPR, MIP, lminlP reconstruction, with PACS system to evaluate the the level, range and character of obstruction of bile duct. Results N-CTCP has good imaging quality. MinlP is worse than MRCP in displaying thin biliary duct ,and SSD ＋ VR reconstitution is similar to MRCP in imaging quality. The veracity rate of the diagnosis to the obstructive character by N-CTCP is 100% （14/14）. Conclusion N-CTCP is a simple and rapid method which costs than MRCP. It can display the anatomy of the bile duct, surrounding tissue and vessels in 3 dimensions. Its imaging quality,capacity of displaying thin bile duct and diagnositic value of obstruction of bile duct are similar to those of MRCP.